Collaborative on innovations in managing obstetric emergencies

Background: Quality of maternity care varies among hospitals across the US. There is a pile-up of guidelines and no process for disseminating best practices – a life-threatening problem because providers need continued training and guidelines on how to deal with obstetric emergencies since maternal mortality is a rare event. Methods: Merck for Mothers, a 10-year $500m initiative to reduce maternal mortality, conducted a landscape analysis of maternal health in the US and conducted consultations with more than 50 experts: CDC, ACOG, AWHONN, AMCHP, IHS and hospital leadership in major cities. Results: Research revealed a clear need to strengthen clinical guidelines, policies and practices to improve facility-level care during labor and delivery. We are hosting an ambitious collaborative among leading maternal health organizations to develop standardized guidelines for the three leading killers in the US – post-partum hemorrhage, eclampsia, embolism – with the goal of scaling nationwide. OB/GYNs, nurses, quality of care experts and hospital administrators will tackle challenges hospitals confront in improving quality of care in the labor and delivery suite – including innovative incentives to encourage adoption of guidelines. Starting with five states with disproportionately high rates of maternal mortality and severe health disparities, the collaborative will explore new ways to standardize quality of care: quantification of blood loss, obstetric drills, patient messages on warning signs and hospital accreditation akin to the “Baby Friendly Hospital” designation. Conclusions: This collaborative presents an opportunity to ensure high quality, measurable and consistent maternity care for every woman, no matter where she delivers.